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MARION COUNTY BUILDING INSPECTION <br />COMMUNIT DEVELOPMENT CENTER <br /> <br />DATE/TINE <br />TYPE <br />OCCUPANCY <br />PAGE <br /> <br /> 285 Church Street NE · Room 132 · Salem, Oregon 97301-3670 <br />Office Hours: 8:00-4:30 · Phone: (503) 588-5147 * 24-HR Inspection Line: (503) 373-4427 <br /> <br />SP <br /> <br />ON-SITE APPLICATION <br /> <br />WORK DE:SC : SP: <br /> <br />EXIST 8EDROOMS~: :3' <br />EXIST EMP[OYEE: <br /> <br />SUBI) [v[r. .. f),.~ : <br /> <br />12:21 <br /> <br />ACTIVITY NO : 76-84:314 <br />STAllJS : APPLIED <br />SE APPLIED : <br />SP APPLIED : 06/14/1976 <br />TO EXPIRE : 12/11796 <br /> <br />AU'I H/FLD <br /> <br /> F'ROPOSEI) BEBROOHS : <br /> PR(POSE.I) EHI LOYEES: <br /> <br />7263.SHAW HY SE AM <br /> <br />~iFY: MARION COUNTY <br /> <br />BLO .K. <br /> <br />PARCEL NHHB.R : 5?788-000 <br /> PARCEL S~ITE : 3~2AC <br /> <br />OWe!ER <br /> NAME <br /> AB1)RESS <br /> <br />~, <br /> <br />AF'PL!CAHT <br /> MAPLE : <br /> ADI)RESS <br /> <br />F H( NE <br /> <br />RATLIF ~ HICHELE <br />726~ SHAW HWY SE <br />AUHSVILLE~ OREGON <br /> 97:t~5 <br />5~$5-74~-~ 245 <br /> <br />RATE :!iff., <br />726~ SH~W HWY SE <br />A[!MSVILLE, OREGON <br /> <br />503-749-1245 <br /> <br />OLC. B~ <br /> <br />Units Descri[,tion FeB <br /> <br /> Assessed 'l~ees 247.00 <br /> Ad just~eots ~ <br /> Total ~'ees 247.~8 <br />F'AYEE: RATt..IFF, '" ~' F 247, <br /> <br />THIS IS NOT A PERMIT. THIS APPLICATION MUST GO THROUGH A REVIEW PROCESS WHERE <br />SOIL, FEASABILtTY AN~ INSTALLATION REQUIREMENTS ARE CHECKED PRIOR TO THE ISSUANCE <br />OF A PERMIT. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT ALL <br />NECESSARY INFORMATION IS PROVIDED. AS SOON AS ALL REQUIREMENTS OF THE REVIEW <br />HAVE BEEN MET, YOU WILL BE NOTIFIED. <br />S:[GI,iATHRE (IF AF'PL:IiCA!4T~ '~JO"~.C.A-~.~_.~ <br /> <br />O[)l,h¥ )") ~.~ W( ,F)LE',,~ i'ihF,'[~Ob! COilhl'iY Bi.)T[I)Ib'.(; OFF:mf. c1A. / BY .LYkIJ-'t <br /> <br />................ FOR OFFICE USE ONLY. THIS IS NOT A PERMIT .................. <br /> NAP:' 51R ZONE: UTF PROPERTY LOCATOR: 082W25AD80108 <br /> <br />SEPTIC REVIEW: DATE: ZONING REVIEW: BATE: <br /> <br /> <br />